Fibrin glue application in microvascular anastomosis: comparative study of two free flaps series.
BACKGROUND
Since the first experiments with fibrin glue application in microvascular anastomoses in 1977, several studies have reported its benefits on suture reduction and anastomosis decreased time. In spite of that, clinical experience has been limited to two neurosurgical and two replantation case series, all of them with good results. This study was conducted to evaluate the feasibility and the potential benefits of fibrin glue application in free flaps.


METHODS
We performed 24 free flaps in 24 patients, from March 2005 to June 2006. Twenty were included in this study. They were divided into two groups according to the anastomosis technique: conventional group (n = 7 patients) and fibrin glue group (n = 13 patients). In the conventional group, the anastomosis was performed with interrupted sutures, whereas in the fibrin glue group, they were performed using less sutures and fibrin glue application.


RESULTS
The application of fibrin glue cut by half the number of sutures required to complete the anastomoses. The mean arterial and venous anastomotic times in the conventional group were 27.2 and 24.0 minutes, respectively. In the fibrin glue group, they were 13.6 and 12.6 minutes, respectively. All these differences were statistically significant. There was no significant difference of ischemic time between two groups (P = 0.26). The survival rate of the flaps was similar in both groups: 84.6% (11 of 13) in the fibrin glue group and 85.7% (6 of 7) in the conventional group (P = 1.0).


CONCLUSIONS
Fibrin glue application in free flaps was feasible and allowed us to complete the anastomoses with fewer sutures and less time. The survival rate of the flaps was not adversely affected by the fibrin glue.
Cho
Alvaro B
AB
Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil. alvarocho73@hotmail.com
Wei
Teng Hsiang
TH
Torres
Luciano Ruiz
LR
Júnior
Rames Mattar
RM
Rugiero
Gustavo Mantovani
GM
Aita
Márcio Aurélio
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D055806:Microvessels / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives